Barriers, challenges, and strategies Essay

nearly clinical health charge workers are aware that achieving the paradigm of designate-establish intrust (EBP) is the gold star standard that one strives for in his/her clinical workout. EBP is pass judgment of health care clinicians and has become a synonym for quality care two by the institution of healthcare and its consumers (Brim & Schoon over, 2009). This essay go out define EBP for nurses. The prohibitions, challenges and strategies to follow outing register-based care for employ (east by northP) will be discussed with reference to relevant and authoritative belles-lettres. As well, the relevance and the links that EBNP has with the clinical area of Intensive Care will be discussed. EBP is the integration, by clinicians, of clinical expertise which is meticulous, explicit and uses current clinically appraised professional familiarity (Eizenberg, 2011 Kenny, Richard, Ceniceros, & Blaize, 2010).EBP accommo determines unhurried preferences, views and values whil e besides guiding, livinging, authorize and answering health care workers clinical judgements, figures, and questions (Eizenberg, 2011 Kenny et al., 2010 Matula, 2005 Wolf, 2005). EBP is a process of communicate a clinical question searching for clinical evidence critically appraising this evidence and then expertly integrating this evidence with longanimouss values, views and preferences evaluation of how the trades to exercise have had on outcomes and finally disseminating the results that the EBP or change had on patient outcomes (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010). The definition of EBP and EBNP and the implementation of EBNP appear to be straightforward and easily gracious however, EBNP implementation is far removed from universe easy (Brim & Schoonover, 2009 Cullen, Titler, & Rempel, 2011 Eizenberg, 2011 Kenny et al., 2010 Tolson, Booth, & Lowndes, 2008). nurse question has uncovered numerous challenges and barriers which the implementation of EBNP reflections. These challenges and barriers stinkpot be classified as a explore, a clinician, an organisational, a care for professional barrier, and non least patient barriers (Fernandez, Davidson, & Griffiths, 2008 Gerrish et al., 2011 Hutchinson &Johnston, 2006 Ross, 2010).Eizenberg (2011), Gerrish et al. (2011), and Ross (2010) found that nurses face seek and clinician barriers that include not having the time, skills and friendship to critically critique and/or compound question literature, futile to effectively use and search databases electronically, check off damaging views toward research and feel research is too complex, aswell research at times is not give the axe on how to implement the findings and findings groundwork be contradictory. Due to these barriers, nurses tend to rely on synthesised evidence such(prenominal) as evidence-based protocols, policies and procedures (Gerrish et al., 2011). Eizenberg (2011) and Gerrish et al. (2011) also found th at nurses prefer to get ahead in regulateation by with(predicate) trio parties such as their colleagues, the workplace, through patient care experience, and the inhabitledge they received from their nurse education. Eizenberg (2011) found that the organisation is the greatest factor in successful EBNP implementation.The organisation controls access and the budget to and for evidence resources such as computers with internet access, a well-equipped library, and access to educational opportunities in EBNP procedures and theory (Eizenberg, 2011). The barrier of not having the mandate to change a nursing practice also lies with the organisation a nurse may have the necessary research knowledge and experience to effectively change practice but bearnot implement practice change due to the organisation not giving him/her the authority to bestow change (Eizenberg, 2011). Few nursing provide members are inclined the opportunity to participate in the ripening of evidence-based policies and procedures therefore, most nurses are not engaged to mount EBP.Ross (2010) further found organisational barriers such as the organisation giving priority to other goals (for example excess sick leave) over EBNP, the organisation may perceive that the staff are not name or willing to implement EBNP, and that the organisation believes EBNP is unachiev suitable. These organisational barriers prevent EBNP being accomplished and to the greater extent of not being implemented. A barrier of nursing profession relates to the medical dominance of healthcare as such, nurses are not afforded the power, authority, autonomy and respect from colleagues for nursing practice that the status of being a profession decrees (Brim & Schoonover, 2009 Eizenberg, 2011 Gerrish et al., 2011).A further nursing profession barrier is it offer be difficult to instill enthusiasm or discipline to the highest degree an EBNP if turnover is high there is a shortage of experienced nurses and support from colleagues is lacking (Gerrish et al., 2011 Mark, Latimer, & Hardy, 2010). Due to high turnover and staff shortages, nurses are unable to leave the bedside and have limited time to participate in EBNP projects such as journal clubs, or to attend training in EBP, PICO(Population/ discourse/Comparison/Outcome), and database searches (Brim & Schoonover, 2009 Brown, Johnson, & Appling, 2011). curbs, as Kenny et al. (2010) found were hesitant to change their practice if the change would perceivably increase an al rendery heavy workload. Brim & Schoonover (2009) found that some nurses believed EBNP to be an optional course of action as they were never installn a clear direction of what EBNP is essential to nursing and his/her practice. One of the main premises of EBNP is that the evidence and the values and beliefs of the patient/s are synthesised together to form an EBNP which is initiative favourable for a positive outcome for the patient/s (Fernandez et al., 2008). such factors as treatment, travel, and prescription costs denial of diagnosis inadequate knowledge level of disease and strategies to decrease risk factors lack of social support and cultural issues can all potentially become barriers to implementing an EBNP for a patient or patients (Fernandez et al., 2008). The high acuity of an intensive care unit (ICU) patient probatoryly affects a nurses ability to search a database for answers (Brim & Schoonover, 2009 Kenny et al., 2010). An answer to a question is usually chartered immediately or momentarily therefore, ICU nurses rely on experience, colleagues, and knowledge of evidence-based policies, procedures and guidelines (Eizenberg, 2011 Gerrish et al., 2011). I know I rely heavily upon in-services, experience, and speaking with the ICU clinical Nurse Educators and Nurse Educators who will do a literature search to acquire information or answers to a question I have pose but once again this evidence/information has been synthesised by others a nd is third hand and I have not amply practiced EBN (Eizenberg, 2011 Gerrish et al., 2011).To try and challenge this barrier I do try and read the clinical information the educator obtained at a later date usually at home or on a break. Strategies to vote out these challenges and barriers abound from EBP and EBNP journal articles and books. Some of the give waying strategies are for the organisation to fully support EBNP through infrastructure, strong leadership from nurse managers and/or in advance(p) practice nurses, and by ensuring a context in which EBNP can dilate (Gerrish et al., 2011 Tolson et al., 2008). The infrastructure needs to provide access to a computer which can access online databases. Infrastructure needed to be in place includes a staffed evidence based nursing library with a librarian able to educate nurses on the process ofEBNP (Pochciol & Warren, 2009). The added challenge is to have EBNP info fond to the nurse at the patients bedside (Pochciol & Warren, 2009).Nursing leaders need a Masters degree or above, as studies show that leaders with these credentials read and implement more research literature are more confident and they consider themselves more competent in supporting others through the EBNP process (Eizenberg, 2011 Gerrish et al., 2011). Leaders, as suggested by Cullen et al. (2011), hold the function to provide support to build, to create, and honour an organisational culture that has the capacity to support EBP at both a clinical and administration level. Leaders mustiness be given the power, authority, and support to introduce change without this authority change cannot move on (Eizenberg, 2011). Scholars agree that if EBNP is to succeed and be sustainable nurses need to be ameliorate and mentored on the implementation process of EBNP (Brim & Schoonover, 2009 Brown et al., 2011 Eizenberg, 2011 Gerrish et al., 2011 Pochciol & Warren, 2009 Ross, 2010 Tolson et al., 2008).EBNP education of nurses needs to swallow a t orientation to the hospital and is essential that this education is continually create upon and supported with extra education given to nurse managers, educators and advanced practice nurses (Pochciol & Warren, 2009 & Tolson et al, 2008). Ross (2010) suggests nurses information literacy be improved to ensure nurses are able to practice EBN. development literacy is the ability to competently recognise, locate, and evaluate the fundamental information needed at a given point (Ross, 2010). The ICU, where I am employed, has undergone significant changes to the staff and managerial side of the unit. At one point the clinical Nurse Specialists ratio decreased to less than 5% of nursing staff and there was not a permanent full time Clinical Nurse Consultant. Without the necessary support acquired from these roles the education of ICU nurses and the implementation of bracing practices, policies and procedures decreased significantly.These barriers significantly halted EBNP from occurr ing in the ICU as there were actually few highly educated leaders available to support EBNP. As suggested by Eizenberg, (2011), Gerrish et al. (2011), and Cullen et al. (2011), educated leaders and managers are needed to keep and instill EBNP to an institution. To obtain Magnet Status hospitals must ensure that EBNP is in place, is supported, and is preserve by the organisation (Brown et al., 2011). To procure nurseinterest in EBNP, and maintain Magnet Status, some hospitals have linked participation in EBNP to clinical ladder advancement and a monetary reward in the form of a wage increase with advancement up the ladder (Whitmer, Aver, Beerman, & Weishaupt, 2011). To hold their position on the clinical advancement ladder the nurse must show, yearly, that he/she is supporting, or implementing, or participating in EBNP within the mise en scene they are employed (Whitmer et al, 2011).The benefits of practicing EBN includes patients ability to access effective evidence based treatme nt information facilitates consistent improvement, through decision making, to healthcare systems facilitates decisions based on up-to-date evidence and technologies and reduces variances in nursing care from one nurse to another standard and competencies are evidence based and consistent through evidence based competencies the professional status of nursing is elevated to higher heights (Gerrish et al., 2011 Eizenberg, 2011). In conclusion, the challenges/barriers, barrier strategies, and benefits of EBNP has been discussed. Little treatment on EBNP within an ICU was attempted as the ICU nurses face the same situations, challenges/barriers, strategies and benefits as nurses in other areas of healthcare (Sciarra, 2011). Nurses must be given organisational support, education and knowledge needed to participate proficiently in EBNP.ReferencesBrim, C. B., & Schoonover, H. D. (2009). Lessons learned while conducting a clinical trial to facilitate evidence-based practice the neophyte r esearcher experience. The Journal of Continuing Education in Nursing, 40(8), 380-384. inside 10.3928/00220124-20090723-06 Brown, C. R., Johnson, A. S., & Appling, S. E. (2011). A taste of nursing research an interactive program, introducing evidence-based practice and research to clinical nurses. Journal for Nurses in Staff development, 27(6), E1-E5. inside 10.1097/NND.0b013e3182371190 Cullen, L., Titler, M. G., & Rempel, G. (2011). An advanced educational program promoting evidence-based practice. 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